BACKGROUND: Low protein diets (LPD) have long been prescribed to chronic kidney disease patients with the goals of improving metabolic abnormalities and postpone the start of maintenance dialysis. METHODS: We reviewed the recent literature addressing low protein diets supplemented with ketoacids/essential aminoacids prescribed during chronic kidney disease and their effects on metabolic, nutritional and renal parameters since 2013. RESULTS: We show new information on how to improve adherence to these diets, on metabolic improvement and delay of the dialysis needs, and preliminary data in chronic kidney disease associated pregnancy. In addition, data on incremental dialysis have been reviewed, as well as potential strategies to reverse protein energy wasting in patients undergoing maintenance dialysis. CONCLUSION: These recent data help to better identify the use of low protein diets supplemented with ketoacids/essential aminoacids during chronic kidney disease.
- MeSH
- adherence pacienta * MeSH
- aminokyseliny terapeutické užití MeSH
- chronická renální insuficience dietoterapie farmakoterapie MeSH
- ketokyseliny terapeutické užití MeSH
- lidé MeSH
- nízkoproteinová dieta * MeSH
- potravní doplňky MeSH
- výběr pacientů MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Many nutritional disorders are associated with the risk of developing hypertension, with increasing severity of hy- pertension and/or with refractoriness to pharmacologic management of hypertension. These nutritional factors include obesity, excessive energy intake, high dietary so- dium, and low potassium intake. There are multiple and complex mechanisms by which obesity and and excessi- ve energy intake increase blood pressure. Increased alco- hol may acutely elevate blood pressure. Higher intakes of potassium, polyunsaturated fatty acids, protein, exercise and possibly vitamin D may reduce blood pressure. Less conclusive studies suggest that certain amino acids, tea, green coffee bean extract, dark chocolate, and foods high in nitrates may reduce blood pressure. Moreover, interacti- ons between medicines and nutrient intake on blood pres- sure have been documented, where some nutrients may potentiate or impair the blood pressure-lowering effects of certain medicines. Of all of these factors, the nutrient inta- kes and nutritional disorders that have the most profound effects on increasing the risk or severity of elevated blood pressure or of raising the refractoriness of elevated blood pressure to medicinal therapy are obesity, excessive energy intake and high sodium diets. Reducing obesity and ener- gy and sodium intake will reduce blood pressure, probably especially in individuals with only mildly to moderately ele- vated blood pressure, or decrease the risk of developing hypertension. A number of dietary regimens may reduce blood pressure, most notably the DASH Low Sodium Diet. Other health enhancement activities also appear to lower blood pressure (e.g., regular exercise). Long term compli- ance with such dietary and lifestyle regimens remain diffi- cult for many people. This field is an active area of scientific investigation and may well reveal additional interactions between nutrient intake, nutritional status and increased blood pressure in the future.
The recent research findings concerning syndromes of muscle wasting, malnutrition, and inflammation in individuals with chronic kidney disease (CKD) or acute kidney injury (AKI) have led to a need for new terminology. To address this need, the International Society of Renal Nutrition and Metabolism (ISRNM) convened an expert panel to review and develop standard terminologies and definitions related to wasting, cachexia, malnutrition, and inflammation in CKD and AKI. The ISRNM expert panel recommends the term 'protein-energy wasting' for loss of body protein mass and fuel reserves. 'Kidney disease wasting' refers to the occurrence of protein-energy wasting in CKD or AKI regardless of the cause. Cachexia is a severe form of protein-energy wasting that occurs infrequently in kidney disease. Protein-energy wasting is diagnosed if three characteristics are present (low serum levels of albumin, transthyretin, or cholesterol), reduced body mass (low or reduced body or fat mass or weight loss with reduced intake of protein and energy), and reduced muscle mass (muscle wasting or sarcopenia, reduced mid-arm muscle circumference). The kidney disease wasting is divided into two main categories of CKD- and AKI-associated protein-energy wasting. Measures of chronic inflammation or other developing tests can be useful clues for the existence of protein-energy wasting but do not define protein-energy wasting. Clinical staging and potential treatment strategies for protein-energy wasting are to be developed in the future.
- MeSH
- akutní nemoc MeSH
- chronická nemoc MeSH
- energetický metabolismus MeSH
- kachexie diagnóza etiologie klasifikace MeSH
- lidé MeSH
- nemoci ledvin komplikace MeSH
- podvýživa diagnóza etiologie klasifikace MeSH
- proteiny metabolismus MeSH
- syndrom chřadnutí diagnóza etiologie klasifikace MeSH
- syndrom MeSH
- terminologie jako téma MeSH
- zánět diagnóza etiologie klasifikace MeSH
- Check Tag
- lidé MeSH
- MeSH
- biologické markery analýza krev metabolismus MeSH
- cholesterol krev MeSH
- dialýza statistika a číselné údaje škodlivé účinky trendy MeSH
- interpretace statistických dat MeSH
- lidé MeSH
- lipidy izolace a purifikace krev MeSH
- míra přežití trendy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- srovnávací studie MeSH
2nd ed. xi, 682 s.
- MeSH
- fyziologie výživy MeSH
- nefrologie MeSH
- terapie MeSH
- Publikační typ
- monografie MeSH
- MeSH
- dialýza ledvin metody normy psychologie MeSH
- peritoneální dialýza metody normy psychologie MeSH
- práva pacientů normy MeSH
- Publikační typ
- přehledy MeSH
American journal of kidney diseases, ISSN 0272-6386 vol. 35, no. 4, suppl. 1, April 2000
S169 s. : il., tab., grafy ; 30 cm
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- nefrologie
Mineral and electrolyte metabolism ; Vol. 22, No. 1-3, 1996
[1st ed.] 202 s. : il.
Kidney international, ISSN 0085-2538 vol. 36, suppl. 27, November 1989
S308 s. : il., tab., grafy ; 30 cm
- MeSH
- ledviny patofyziologie metabolismus MeSH
- nemoci ledvin MeSH
- Publikační typ
- kongresy MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- nefrologie
- nutriční terapie, dietoterapie a výživa
